Ayurvedic levodopa source effective in small trial

A natural source of levodopa used in traditional Ayurvedic Indian medicine may have some advantages over conventional preparations in the management of Parkinson's disease, a report in the Journal of Neurology, Neurosurgery and Psychiatry suggests.Dr. AJ Lees and colleagues set out to assess the value of the seed powder of the leguminous plant, Mucuna pruriens, long used in Ayurvedic medicine for diseases including parkinsonism. They compared clinical effects and levodopa (L-dopa) pharmacokinetics after two different doses of mucuna preparation and standard L-dopa/carbidopa (LD/CD) in eight patients with a short duration L-dopa response and on period dyskinesias completed a randomised, controlled, double blind crossover trial. The patients were challenged with single doses of 200/50 mg LD/CD, and 15 and 30 g of mucuna preparation in randomised order at weekly intervals. Dr. Lees' group determined L-Dopa pharmacokinetics, and obtained Unified Parkinson's Disease Rating Scale and tapping speed scores at baseline and repeatedly during the 4 hours following drug ingestion. Compared with standard LD/CD, the 30 g mucuna preparation led to a considerably faster onset of effect, reflected in shorter latencies to peak L-dopa plasma concentrations, the authors report. Mean on time was 21.9% (37 min) longer with 30 g mucuna than with LD/CD; peak L-dopa plasma concentrations were 110% higher and the area under the plasma concentration v time curve (area under curve) was 165.3% larger. No significant differences in dyskinesias or tolerability occurred. "Based on this preliminary pilot study in patients with PD and short duration L-dopa response, the 30 g M pruriens formulation seems to possess potential advantages over existing commercially available controlled release or dispersible formulations of L-dopa in that it combines a rapid onset of action with a slightly longer duration of therapeutic response compared with a dose of standard L-dopa calculated on the basis of the known quantity of L-dopa in mucuna using standard conversion ratios," they conclude. "Further analysis of the seeds'content may reveal further explanations for the differences in the pharmacokinetic profiles found in this study. If these findings can be confirmed in larger and longer term studies, mucuna would seem to be a reasonable commercially viable alternative to standard L-dopa," they write.Reference...